Wolde Yisehak, Samuel Sintayehu, Abebe Teketel, Gebrehiwot Gediwon, Reshad Selman, Amsalu Hunde, Alemnew Sara, Dedachew Yidnekachew, Desalegn Mitiku
Department of Anaesthesia, College of Medicine and Health Science, Wachemo University, Hosanna, Ethiopia.
Obstetrics and Gynaecology, Wachemo University College of Medicine and Health Science, Hossana, Ethiopia.
BMC Anesthesiol. 2024 Dec 20;24(1):470. doi: 10.1186/s12871-024-02854-6.
Hemodynamic changes are independent risk factors for long-term patient morbidity and duration of hospital stay. According to the statistics, the three most prevalent complications in the postanaesthesia care unit were airway events, haemodynamic instability, and postoperative nausea and vomiting. Hemodynamic instability in the postanaesthesia care unit can result in serious complications, such as long-term patient morbidity and prolonged hospital stays. This study aimed to determine the incidence and factors associated with haemodynamic changes among adult surgical patients in the postanaesthetic care unit.
An institution-based observational study was conducted from December 1, 2023, to June 30, 2024. In addition, 409 adult surgery patients participated. We employed consecutive sampling techniques and both analytical and descriptive statistics to explain our findings. Using both bivariable and multivariable logistic regression, we evaluated the strength of the association and determined the crude odds ratio and adjusted odds ratio with a 95% confidence interval. A p value of less than 0.05 was considered statistically significant in the multivariable regression.
The incidence of hemodynamic instability was 53.8% (CI: 45%, 64%). The incidences of hypotension, hypertension, tachycardia, and bradycardia were 24.2%, 17.45%, 31.3%, and 12.6%, respectively. ASA class III, procedures with more than 4 instances of intraoperative haemodynamic instability and neuraxial anaesthesia were significantly associated with haemodynamic instability in the postanaesthetic care unit.
In general, 93 study subjects (22.7%) experienced advanced haemodynamic instability during the intraoperative period. This implies that the incidence of hemodynamic instability was high. Intraoperative haemodynamic instability, American Society of Anaesthesiology class III, postoperative respiratory adverse events, neurologic and gynaecological procedures, use of neuraxial anaesthesia, and prolonged duration of procedures were predictors of haemodynamic instability in the postanaesthesia care unit.
血流动力学变化是患者长期发病和住院时间的独立危险因素。据统计，麻醉后护理单元中最常见的三种并发症是气道事件、血流动力学不稳定和术后恶心呕吐。麻醉后护理单元中的血流动力学不稳定可导致严重并发症，如患者长期发病和住院时间延长。本研究旨在确定麻醉后护理单元中成年外科手术患者血流动力学变化的发生率及相关因素。
于2023年12月1日至2024年6月30日进行了一项基于机构的观察性研究。此外，409名成年外科手术患者参与其中。我们采用连续抽样技术以及分析性和描述性统计来解释研究结果。使用双变量和多变量逻辑回归，我们评估了关联强度，并确定了粗比值比和调整后的比值比以及95%置信区间。在多变量回归中，p值小于0.05被认为具有统计学意义。
血流动力学不稳定的发生率为53.8%（置信区间：45%，64%）。低血压、高血压、心动过速和心动过缓的发生率分别为24.2%、17.45%、31.3%和12.6%。美国麻醉医师协会（ASA）Ⅲ级、术中血流动力学不稳定超过4次的手术以及神经轴索麻醉与麻醉后护理单元中的血流动力学不稳定显著相关。
总体而言，93名研究对象（22.7%）在术中经历了严重的血流动力学不稳定。这意味着血流动力学不稳定的发生率很高。术中血流动力学不稳定、美国麻醉医师协会Ⅲ级、术后呼吸不良事件、神经和妇科手术、神经轴索麻醉的使用以及手术时间延长是麻醉后护理单元中血流动力学不稳定的预测因素。
